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1972521094
JEAN WANAMAKER
BAY SHORE, NY
NPI
1972521094
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 008922)
Enumeration Date
2006-07-17
Last Update Date
2007-10-09
Business Address
Ms. JEAN WANAMAKER PA
301 E MAIN ST
BAY SHORE, NY 11706-8408
Phone number: 631-968-3000
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Mailing Address
Ms. JEAN WANAMAKER PA
301 E MAIN ST
BAY SHORE, NY 11706-8408
Phone number: 631-968-3000
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